ONLINE SPEAKING ENGAGEMENT REQUEST FORM

To assist us in serving your needs and effectively representing AOPA, we ask that you complete this form as part of any invitation for the President, or another AOPA representative, to speak at or participate in an event.

Event Name Event Location Event Date Event Time Time of President's Participation/Involvement

NOTE: The times requested for the President's participation should be as exact as possible, as we may schedule multiple events the same day.

What time will the majority of the guests arrive? Contact Name Phone Number Email Address Attire Type of Event Please describe: Is the President being requested to speak? In the event the President is not available, would you be interested in having someone else from AOPA? How much time allotted for the speech? Will speech be followed by a Q & A session? If so, how long? Please indicate what level of participation the President would have in your event What is the group's objective in having the President speak or attend? Does the group have any special interests or concerns that should be addressed? Is there a topic or subject that should be addressed in the speech? Anticipated number of attendees? How many people attended the event in the past or the last time it was held? Please list past speakers: Should the remarks be formal or conversational? Please describe the audience Is there anything else that you would like for us to know about your event?

_{Please review AOPA’s privacy policy to learn more about how your information is used.}